The New Hampshire Nurse Practitioner Association, representing licensed prescribers working in the state of New Hampshire, stands in strong support of Gov. Chris Sununu’s veto of HB 1022, permitting pharmacists to dispense the drug Ivermectin by means of a standing order. We urge members of the House and Senate to vote against any motion to override the veto of HB 1022 when they return to Concord on September 15th.

As the governor’s June 24 veto message stated: “The State currently only has four instances in which pharmacists can dispense medication without a prescription. These medications are smoking cessation, contraception, substance use disorder, and treatment for sexual assault, all of which have gone through rigorous reviews and vetting to ensure they meet all the necessary protocols prior to a medication being dispensed via standing order. All drugs and medications should be subject to that same rigorous process if they are to be dispensed by standing order.”

NHNPA’s testimony on HB 1022 in January cited this 2021 statement from the National Institutes of Health: “There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of Ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of Ivermectin in the treatment of COVID-19.”

Our earlier op ed on this subject observed that the Legislature heeded only part of this advice when considering HB 1022, and the result was passage of a bill that does two things: permits pharmacists to dispense the drug Ivermectin by means of a standing order, and at the same time establishes a commission to study the use of Ivermectin to treat Covid-19. This could be very aptly called “putting the horse before the cart” because Ivermectin is most commonly used as a de-wormer for horses. Further, establishing a committee to study the role of Ivermectin in COVID-19 while we have easily accessible high quality, randomized controlled studies that clearly indicate lack of efficacy/benefit is a misguided focus and waste of resources of New Hampshire lawmakers.

In 2021, after the use of Ivermectin to treat COVID-19 became a social media-inspired practice, the U.S. Centers for Disease Control and Prevention (CDC) and the FDA issued advisories indicating that the anti-parasitic drug is not authorized or approved for the prevention or treatment of COVID-19. The National Institutes of Health, World Health Organization, and Merck, the manufacturer of the drug, have all stated that there is insufficient evidence to support the use of Ivermectin to treat COVID-19. The Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 also recommended against the use of Ivermectin outside of a clinical trial.

The NH Nurse Practitioner Association joins with the American Medical Association, American Pharmacists Association (APhA), and American Society of Health-System Pharmacists (ASHP), and other health care advocates and organizations, to strongly oppose the ordering, prescribing, or dispensing of Ivermectin to prevent or treat COVID-19 outside of a clinical trial. We strongly urge that our legislators listen to the experts and sustain the governor’s veto of HB 1022.

Siobhan Benham, APRN, of Peterborough and S. Nicole Condodemetraky, APRN, of Bedford are members of the New Hampshire Nurse Practitioner Association.

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